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IPEM welcomes this report but would recommend that the document emphasises the need to consult with medical physicists, either via a Medical Physics Expert or Radiation Protection Adviser as appropriate, to assist with patient and staff dose optimisation.

Paragraph 47 – could mention wearing protective gloves when supporting patient, even if the hands are just exposed to scattered radiation, in order to keep dose ALARP.

Section 4.4.6 – this need to switch off automatic brightness control during procedures may be equipment dependent and as such this section could be misleading. The advice of the Medical Physics Expert should be sought with regard to optimizing equipment parameters for paediatric radiography.

Paragraph 96 – should state that hand exposure to primary radiation should be avoided. Bullet point 5 (page 39) should state that gloves do not provide sufficient shielding from primary radiation. Bullet point 7 (page 39) could be clarified.

Section 5.3 – could note that users should be aware of the relative difference in dose rates between fluoroscopy & acquisition, perhaps with example ranges to empasise the need to keep acquisition runs to a minimum.

Page 41 – table 4 seems to be in the wrong place

Chapter 6 - radiological protection in paediatric computed tomography

Section 6.3 – this section may be too in depth. A description of Dose Length Product should be included.

Chapter 7 – summary & recommendations

Could add that the advice of an Medical Physics Expert should be sought to assist with setting imaging protocols and optimization.